Association of smokeless tobacco use and smoking in adolescents in the United States : An analysis of data from the Youth Risk Behavior Surveillance System survey, 2011

ABSTRACTBackgroundUsing smokeless tobacco and smoking are behaviors that increase the risk of developing oral cancer, soft-tissue lesions, caries, periodontal disease and other oral conditions. The author conducted a study to examine use of smokeless tobacco and smoking by adolescents.MethodsThe study was a cross-sectional analysis of participants with complete data regarding smoking, smokeless tobacco use and other variables of interest from the 2011 national Youth Risk Behavior Surveillance System survey (n = 9,655). The author performed descriptive analysis and multivariable logistic regression analyses.ResultsThe unadjusted odds ratio for smokeless tobacco use and smoking was 9.68 (95 percent confidence interval [CI], 7.72–12.13; P < .0001), and the adjusted odds ratio was 3.92 (95 percent CI, 2.89–5.31; P < .0001). Adolescents who used smokeless tobacco were more likely to be male, to smoke and to have engaged in binge drinking.ConclusionAdolescents who were using smokeless tobacco were more likely to be engaging in concomitant smoking and to be participating in other risk-taking behaviors.Practical Implications. Dentists are involved in helping patients with tobacco-use cessation. The association of smoking with using smokeless tobacco needs to be considered in the design of tobacco-use cessation programs for adolescents.